Tanzania S&H Assessment Report
Chapter 1: Introduction
Methodology:
The development of this Tanzania sanitation and hygiene sector assessment comprised of the following activities – Went through the assessment questions provided with the Strategy Development Guidelines to identify requirements and approach. A desk study was conducted to review relevant sector documents such as – the existing country sector strategy documents, sector review reports, gap analyses and the GSF UMATA programme documents. A set of selected question items was e-mailed to the Tanzania WASH coalition members, key sector partners and stakeholders. Own knowledge of the sector by NC has been an input to the key responses in this document. Towards finalisation of the assessment, a S&H workshop will be convened to discuss the findings of the assessment and agree key areas of strategy focus.
Country Overview
Tanzania is East Africa’s most populous country with a population of 45 million of which almost 75% live in rural areas.Tanzania is considered to be among the group of 25 poorest countries of the world. Per capita income is estimated at US $ 535 in current terms[1]. According to the UNDP, Tanzania ranks 152 out of 187 countries[2]. The Tanzania Human Development Report (THDR) data show that the proportion of the population below the basic needs poverty line declined only slightly from 35.7% in 2000/1 to 33.6% in 2007, and the incidence of food poverty fell from 18.7% to 16.6% over the same period[3]. However, during the past ten years, the annual population growth rate of 2.7% increased the absolute number of Tanzanians living in poverty by more than 1 million. Statistics show that only 23% of the rural population and 27% of the urban population respectively have access to improved sanitation facilities.This implies that 8 million urban dwellers and 26 million in rural Tanzania have no access to improved sanitation facilities. The access is lowest in nomadic communities with sanitation access at less than 12%.[4]
Tanzania is one among the developing countries with the highest Burden of Diseases (BoD). At the same time it is understood that sanitation and hygiene is the key to sustainable livelihoods. According to the World Health Organization (WHO), 70% of diseases in Tanzania are water related and it is estimated that these cost Tanzania close to US$ 600 million annually.As such, without significant improvements in governance, health, healthcare systems, sanitation and hygiene, Tanzania faces the risk of overwhelming an already-fragile social service system and eroding future economic gains.
Policy and Legislation:
Water and sanitation policies in Tanzania are developed in line withDevelopment Vision 2025and the National Strategy for Growth and Reduction of Poverty, (NSGRP) 1 and NSGRP 2 better known as Mkakati wa Kukuza Uchumi na Kupunguza UmasikiniTanzania(MKUKUTA) in Kiswahili. The importance of water supply and adequate sanitation is recognised in the second cluster of MKUKUTA. Here, one of the primary goals is to achieve "increased access to clean, affordable and safe water, sanitation, decent shelter, and a safe and sustainable environment."Besides, the S&H policies draw influence from Tanzania’s commitment to the Millennium Development Goals (MDGs) as well as its commitment to other international Agreements/Charters (eg the eThekwin).
The MoHSW has led the development of theNational Sanitation and Hygiene Policy, which has already been submitted to Cabinet awaiting approval. The objective of the policy is to strengthen the countries efforts to improve sanitation and hygiene practices and it details harmonized definitions, the first step to developing and implementing an effective M&E framework for sanitation and hygiene in Tanzania. The MoHSW has also developed a ten-year National Environmental Health, Hygiene and Sanitation Strategy (NEHHSAS) 2008-2017, which outlines options for improving sanitation that include promotional, educational and participatory approaches and methods. Also the four lead ministries - MoHSW, MoEVT, MoWI and PMO-RALG; and other actors developed the SWASH Strategic Plan under leadership of MOEVT.
TheNational Water Sector Development Strategy(NWSDS) of 2006sets out a strategy for implementing the National Water Policy(NAWAPO)of 2002.The NAWAPO aims to achieve sustainable development in the sector through an "efficient use of water resources and efforts to increase the availability of water and sanitation services." It is guided by the principles of decentralization and localization of management and services.
The legal framework for water supply and sanitation is based on theWater Supply and Sanitation Act No. 12enacted in May 2009. The Act outlines the responsibilities of government authorities involved in the water sector, establishes Water Supply and Sanitation Authorities as commercial entities and allows for their clustering where this leads to improved commercial viability. It also provides for the registration and operation of Community Owned Water Supply Organisations (COWSOs) and regulates the appointment of board members.
Gaps and issues –
i)Approval of the National Sanitation and Hygiene Policy has stagnatted in the Cabinet Secretariat for two years (at the time of this writing). This is indicative of the fact that sanitation and hygiene is not accorded the importance and priority that it deserves in the face of policy makers.
ii)There is lack of supportive inclusive policy, legislation and regulatory framework for the S&H sector that could take into account the rights of marginalized groups in access to -and use of – sanitation and hygiene services.
iii)Much as policy states that investment for sanitation at household level is the responsibility of the household, it does not state clearly the responsibility of LGAs to provide sanitation and hygiene services at public places (eg markets, bus stands etc.). Instead it only states an inclusive responsibility “to provide services at public places”. Due to this, majority of bus stands and markets have very poor sanitation services.
iv)Sector documents are not comprehensive, and most with polarised attention to water with little or no emphasis on sanitation.
v)Paucity of sector coverage data , lack of cross-sector collaboration, weak policy focus, weak capacity for articulation of WASH issues at Local government level, weak national –subnational –local policy linkages, fragmented sectoral approaches, epileptic sector dialogues
vi)There is a big need for stakeholders and partners to come together for demand of an official response from the government on approval of the policy. Absence of a policy contribute to reluctance of key players to support the sector. WSSCC could play role in this subject
Institutional Development:
The provision and promotion of adequate sanitation and hygiene falls under the Ministry of Health and Social Welfare (MoHSW). Other key players in the sector include – the Ministry of Water (MoW)responsible for overall water policy setting, co-ordination, monitoring, evaluation and regulating community water supplies.The Ministry of Education and Vocational Training (MoEVT) is responsible for hygiene education and the provision of sanitation in schools. Decentralization in the Tanzanian water and sanitation sector has transferred responsibilities for service provision to Local Government Authorities (LGAs) under the Prime Minister’s Office-Regional Administration and Local Government (PMO-RALG). The LGAs comprise 160 municipal, districtand town councils: they are responsible for the procurement, financing, management and monitoring of service providers in their areas of jurisdiction. Apart from the government there are also other non-governmental actors which are, as well involved in the provision of sanitation and hygiene services. These include – UN organizations like UNICEF, development partners such as the WSP and GIZ,Kfw, development organizations and international NGOs like AMREF, WaterAid (T), Plan International (T), World Vision, Oxfam, Concern Worldwide,CARE International (T) and a wide range of national NGOs and FBOs.
This multiple involvement by ministries and departments has resulted in overlap of roles and responsibilities. The overlap has been blamed to be one of the reasons that led to the lagging behind of sanitation development in Tanzania. In response to the challenges posed by this situation, in 2009, the four ministries developed a memorandum of understanding (MoU) to outline a coordinated mechanism for the implementation of sanitation, hygiene and school WASH as well as to feed into three national sector programmes – Health, Water and Education.
Gaps and issues –
i)The MoU Sanitation & Hygiene Coordination Structure with linkages to sector decision making bodies indicated - ie The National Sanitation & Hygiene Steering Committee (NSHSC) Chaired by MOHSW (scheduled to meet 2 times a year); The Water Sector Development Programme (WSDP) - Water Sector Working Group (WSWG) (scheduled to meet 4 times a year); and The MOHSW Management Committee (scheduled to meet weekly). This coordination structure has not been able to function adequately. Crucial issues (eg of sanitation and hygiene financing, equity, access and use by the marginalized groups etc.) which should have been addressed by this structure have not been taken up by this mechanism.
ii)The financing of the coordination structure has been a problem – reports show only UNICEF has been footing the bills.
iii)Guiding frameworks are generally weak ,cross-sectoral linkages not common, institutional capacity at local government level skewed , coalitions usually ad hoc without sustainability plans, Lead institutions emphasis on few areas and not considering comprehensiveness
Financing of S&H
Sanitation financing in Tanzania is contributed by the Central Government from basket funds through the MoHSW’s, MoEVT, MoW’s and PMO_RALG; External contribution from WHO, World Bank, AfDB, The Netherlands Government, GIZ, Belgium and International NGOs; and Civil Society Organizations together with community contribution. Studies have shown that in Tanzania there is insufficient domestic financing for WASH overall, with particularly serious shortfalls for sanitation. This is exacerbated by difficulties in spending the limited funds that are received[5]. The Average annual commitments to sanitation and drinking-water, 2008–2010 has been US$ 150 millions, (grants and loans).
Financing sanitation haas been coming through an coordinated mechanism, they are mostly project based and not supporting to the program. There is no such program to focus as a nation. It is only now that there is a national sanitation campaig and UMATA program, it is expected to draw attention of coordinated investment to improve sanitation in the country.
Financing gaps and issues:
i)Coordination difficulties with Ministries;
ii)Identification of sustainable S&H funding/resource mobilization solutions;
iii)There is more emphasis on new building, not on rehabilitation;
iv)S&H is not clearly visible in district and ministerial plans and budget lines.
v)Sanitation and Hygiene usually masked by Water which appears to politically appealing to policy makers and even communities, and therefore mask Sanitation and Hygiene
Urban – rural divide
The NAWAPO provides for the institutional framework for dealing with water supply and sanitation services in urban areas as well as rural areas in Tanzania. Inmajor urban areas (cities/ municipalities and Towns), the maintenance and development of water and sewerage infrastructure is carried out by autonomous legal entities – the Urban Water Supply and Sanitation Authorities (UWSSAs). The UWSSAs are meant to operate commercially. In accordance with theWaterworks Act No. 8of 1997, 19 UWSSAs have been established in major urban areas. In 2001, the Dar es Salaam Water and Sewerage Authority - DAWASA - was established to serviceDar es Salaamand two districts ofPwani Region.
As for districts and townships,in 2007, MoW initiated a process of clustering affecting over one hundred utilities, the District Urban Water Supply and Sanitation Authorities (DUWSSAs). Its aim is to increase the quality and efficiency of service.However, as of 2012 clustering had made little progress because it runs against the on-going overall decentralization process. Donor agencies such as GIZ have thus stopped their support for clustering. Urban and district water utilities are not responsible for on-site sanitation, which remains in the hands of the respective LGAs.
On the part of rural areas, water supply and sanitation services are provided by Community Owned Water Supply Organisations (COWSOs) established through the local governance framework of village governments in line with the Water Sector Development Strategy. There are two types of COWSOs - Water Consumer Associations responsible for drinking water supply; and Water User Associations responsible for water resources and for solving conflicts among water users. The role of COWSOs is to operate and maintain the water supply systems on behalf of the community. They are expected to meet all the costs of operating and maintaining their water supply systems through charges levied on water consumers, and to contribute to the capital cost of their systems.
Urban-rural divide gaps and issues:
i)While policy directs that the cost of sanitation should be born by the household (mainly in the rural areas) in the urban areas, the UWSSAs render highly subsidized sewerage services to urban dwellers who are comparatively the rich. This, in a way is an equity and governance issue because most of the decision makers are the ones with access to sewerage services.
ii)*Weak Local Government capacity to promote Sanitation and Hygiene is constraint as well. Key focus in local government is enforcement and not promotion. *Awareness on sanitation and Hygiene is low as one moves from urban to rural(lowest investment at household level is evident .
Chapter 2: Assessment results
On-going S&H Programmes
Apart from the GSF-funded UMATA programme, there is a number of ongoing interventions like- The Water Sector Development Programme (Water SWAp) with a sanitation and hygiene component to water projects. This component is managed under the MOHSW through the National Sanitation Campaign that has been already launched and ongoing. There is the WSP intervention - the Total Sanitation and Sanitation Marketing (TSSM) in 10 districts and Hand Washing Programme. There is an ‘advocacy alliance’ under MOHSW of actors working on sanitation and hygiene, who have been coordinating efforts to advocate for sanitation and hygiene across Tanzania using the mass media and event based activities. The Village Health and Environmental Health and Sanitation Programme supported by the MoHSW; and a regular annual Environmental Health and Sanitation Competition conducted by MoHSW.
There are also significant SWASH or S&H programmes by: Plan International has continued to support CLTS in their focus districts, WaterAid is supporting S&H using Mtumba Approach in 15 districts.GLOWS in Morogoro (SWASH); GIZ in Mbeya (SWASH) using WASH United campaign; UNICEF in 11 districts in Tanzania and on the 10 districts of Zanzibar (S&H – PHAST and sanitation artisan training and SWASH); The Concern WorldWide Tanzania has S&H programmes in Ngara, Kibondo and other refugee relief areas.
There are more incoming supporters to S&H like USAID, JICA, BTC ( Belgium Technical Cooperation) who are inputting resourses in the sector, but need more engagement to understand.
S&H Approaches and Harmonization
A number of different sanitation and hygiene approaches have also been introduced into Tanzania over the past few years. These include:
1)The Community-Led Total Sanitation (CLTS) – supported by Plan International
This approach aims to stop all open defecation (OD) within a community through community self motivation. The approach encourages innovation and commitment within the community, motivating them to build their own sanitation infrastructure using the main motivator of disgust, without depending on hardware subsidies from external agencies.
2)The Mtumba Approach – supported by WaterAid.
This approach draws on the CLTS and sanitation marketing approaches, with households (consumers) ‘triggered’ to invest in sanitation improvements using their own financial resources. It uses participatory approaches, borrowing and modifying tools from PHAST, CLTS, and PRA and adapting them to the Tanzanian context. Besides, Mtumba focuses on demand creation through sanitation marketing, and as such offers a wide range of latrine options displayed in sanitation centres that are managed by trained artisans and community mobilizers.
3)Total Sanitation & Sanitation Marketing (TSSM) – supported by WSP
The TSSM programme includes two main approaches: CLTS approach to stimulate demand, paired with sanitation marketing techniques to further strengthen the demand and to improve supply. In Tanzania it is also coupled with the Global Scaling Up Hand Washing Project in some of the 10 project districts as well as national radio slots.
Issues and gaps:
i)Harmonisation and cross fertilisation has been a big challenge since the different approaches are used by different actors. Each programme Project promotes what is in their philosophy or belief (what has proved to work !) However MOHSW has been bringing together partners to discuss these approaches for the purpose of harmonizing them and agree what to follow as a nation. The National Sanitation Campaign implemented by MOHSW is promoting sanitation using reviewed CLTS and TSSM. The GSF-funded UMATA also is going as the MOHSW in order to benefit from the strengths of each approach. There is no alignment of programme implementation.)
ii)No common S&H IEC strategy for the sector that is to be used in campaigns, although the NSC and GSF are aiming to achieve that.
Role of Government in Implementation
In an ideal decentralized system, programme implementation is mainly at local level where the LGA provides resources and guidance for setting; achieving and maintaining the targets set by institutions/ structures established in the LGA planning system. The LGA and its CSOs advocate at national and district levels for equitable and adequate resources, coordinates local environmental health service providers; and monitors and supervises implementation of water, sanitation and hygiene guidelines in schools and health facilities as part of the routine monitoring and inspection process.
However the real situation does not work like that. Sanitation and hygiene plans are not clearly feature in the plans, partners working in the particular district are rarely involved in the planning and budget setting process or even thy don’t share their plans as input to the district. The general coordination still needs to be strengthened at local and national level, although key players play part in national meetings there is a need to devise reporting mechanism so that all information are known to stakeholders .